Lincolnshire hospitals paid out £7m last year for birthing negligence

Lincolnshire hospitals paid out more than £7.2 million last year in obstetrics and maternity compensation relating to medical negligence.

The figure has been obtained by The Lincolnite through a Freedom of Information (FOI) request to United Lincolnshire Hospitals Trust (ULHT).

Between January 1 and December 31, 2013, ULHT spent a total of £7,225,000 in relation to four cases.

The sum is paid out by the NHS Litigation Authority, and includes resolution to a case which originated several years ago.

Throughout the year, two of the four cases were made public through the courts.

One boy was awarded one of the highest settlements in NHS history after his birth at Lincoln County Hospital.

Aaron Crosby (9) from Lincoln was awarded £10 million in compensation, with a £3.25 million immediate payout, after his mother was given an overdose of a contraction stimulant, starving the baby of oxygen.

Aaron was left with brain damage, athetoid cerebral palsy and epilepsy.

He is wheelchair bound, cannot talk and cannot use any of his limbs. He requires 24-hour care.

ULHT admitted liability for the case and apologised to Aaron and his family.

The second reported case involved a teenage boy from Lincoln who suffered severe brain damage during his birth at Lincoln County Hospital. He was awarded an upfront sum of £2.65 million.

The boy, who was not named for legal reasons, suffered severe cerebral palsy due to being starved of oxygen while being born in the 1990s.

ULHT denied liability for the boy’s delivery, stating midwives worked “diligently”, but agreed to the multi-million settlement.

Compensation for the two other cases, which have not been disclosed, amounts to more than £1.3 million.

Addressing standards

Between April 2004 and October 2013, ULHT dealt with 162 clinical negligence claims in the obstetrics and maternity department.

The Trust said that it has received a recent uplift of 10 new midwives and that there are no current vacancies.

Across Lincolnshire, the birth to midwife ratio now stands at 1:28 – a figure just below the recognised benchmark of one midwife to 29.5 births.

A ULHT spokesperson said: “Our maternity and obstetrics departments follow National Institute for Health and Care Excellence guidelines and have measures in place to manage clinical risks.

“As well as the new birthing pool at Lincoln County Hospital and the recruitment of additional midwives, we are in the process of developing an antenatal day care setting to reduce length of stay for antenatal patients, and we regularly review any incidents and share lessons learned.

“The Lincoln County Hospital is one of few units in the East Midlands that provide a 60 hour consultant presence on the labour ward.

“This is a national standard recommended by the Royal College of Obstetricians and Gynaecologists. This ensures that a senior obstetrician is physically present during peak times of activity on the labour ward.

“The hospital has been providing a 7-day consultant presence even before it became a national requirement.

“Practices and guidelines regularly change, and we always ensure our practices are in line with national guidance,” the ULHT statement added.

The national picture

A report for the year 2012 by the National Audit Office on Maternity services in England, published in November 2013, highlighted that although national mortality rates have fallen over time, litigation in maternity care is rising.

The report showed that £482 million a year, almost a fifth of the NHS budget for maternity services, is being spent on medical negligence cover, which equates to an estimated £700 per birth.

In 2012-13, there were 1,146 clinical negligence claims relating to maternity care, equivalent to around one claim for every 600 births.

The average payment per claim in the UK, between 2012 and 2013 was £277,000.

The number of claims increased by 80% in the five years from 2007-08 to 2012-13, which is consistent with the rise in claims across the NHS as a whole (88%).

Over the last decade, the most common reasons for maternity claims have consistently been mistakes in the management of labour and relating to caesarean sections, and errors resulting in cerebral palsy.

The NAO also reported that to meet a widely recognised benchmark of one midwife to 29.5 births, the country would require around 2,300 additional midwives.

The average time from an incident occurring to a claim being resolved is over four years and therefore it is difficult to draw conclusions about the quality and safety of current care from the claims that have been settled.

NAO found that 79% of women are currently within a 30-minute drive of both an obstetric and midwifery-led unit, compared with 59% in 2007.

However, choice is restricted where units have to close because of a lack of physical capacity or midwives.